Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RACGP > ophthalmology > Flashcards

ophthalmology Flashcards

1
Q

DDx of red-eye according to anatomy (8)

A
  1. eyelid
    • blepharitis
    • chalazion
    • hordeolum (stye)
  2. Dacryocystitis
  3. conjunctiva
    • bacterial conjunctivitis –> mucopurulent discharge
    • viral –> watery, URIT, LN, follicle (big and white)
    • allergic –>itching, gritty, papillae (red and red)
    • dry eye –> watery, gritty, contact lense
    • subconjunctival haemorrhage –> unilateral, no pain
  4. episcleritis–> unilateral, focal, mild pain

the rest are photophobia, decreased vision, severe pain

  1. scleritis: focal
  2. cornea
    • keratitis
    • corneal FB/abrasion/ulcer
  3. Iritis / ant. uveitis
  4. glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DDx of Lukocoria (white reflection) in children

A
  1. Retinoblastoma
  2. coat’s disease: exudate and new blood vessels in the retina
  3. retinopathy of prematurity (RoP)
    • premature < 27/40
    • VLBW < 1200 g
  4. retinal detachment: trauma
  5. Persistent hyperplastic primary vitreous (PHPV)
  6. Toxocariasis: infection of retina when contact with dogs/cats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

signs to suspect penetrating eye injury

A
  1. shallow (flat) ant chamber
  2. blood in ant chamber (hyphema)
  3. iris prolapse
  4. subconjunctival haemorrhage
  5. decrease visual acuity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

name of the diagnostic test of penetrating eye injury

A

Seidel test

fluorescein dye –> see leaking from ant chamber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

penetrating eye injury- Mx in GP

A 
Cover the eye with a coffee cup
Avoid pressure
Fasting 
Urgent referral 
Do not do IOP
Do not remove FB as risk of global herniation and collapse
Give ADT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

penetrating eye injury- complications

A 
Intraocular infection
Traumatic cataract
Retinal damage/detachment
Vitreous body damage
glaucoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Retinal detachment

A

C/F
Carten visual loss
Flashes
floaters

DDx:
Retinal tear
Post vitreous body detachment (floaters)
Vitreous body haemorrhage
Migraine
R/F
Myopia
Age
Previous eye surgery
Traum
Systemic disease
DM
Marfan disease

Mx:
Urgent referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Trachoma /chlamydia trachomatis

A

Trachoma /chlamydia trachomatis

ATSI disease

C/F
Chronic disease
Eye discharge in the morning only, cleaned with washing the face
Itching
No other symptoms

O/E
tarsal conjunctiva > 5 follicle (whtie and big) (diagnostic)
Inturned eyelashes: due to recurrent eyelid scarring
Corneal abrasion and blindness: due to eyelashes

Non-pharmacological management
Avoid overcrowding
Clean water
Good eye hygiene
Contact tracing
Monitor whole family
Notify public health

Treatment:
Azithromycin 20mg/Kg PO STAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diabetic retinopathy

A

Diabetic retinopathy

R/F

- Uncontrolled BSL
- HTN
- dyslipidemia

Retinal finding
- Cotton wool
- Exudate
- Dot haemorrhage
- Microaneurysm and new blood vessels
- Macular oedema: all stages of diabetic retinopathy
If near centre called CSME (clinical significant macular oedema)

Severity and classification

- NPDR = non proliferative diabetic retinopathy
- PDR = proliferative diabetic retinopathy

Mx:

- Control BSL
- Control BP
- Add fenofibrate 145mg PO daily
- Check visual acuity
- Referral to ophthalmologist
- Fall prevention strategies

Treatment:

- Laser
- VEGF Ab (vascular endothelial growth factor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hypertensive retinopathy finding

A
  1. AV nipping
  2. sliver wiring
  3. haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ant uveitis is associated with (5)

A 
Ankylosing spondylitis
Inflammatory bowel disease (UC)
Sarcoidosis
Behcet syndrome
Juvenile idiopathic arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Optic neuritis

A

occur in 20 % of Multiple sclerosis
50% of MS cases has optic neuritis

C/F

  • young women
  • sudden mono-ocular central vision loss
  • eye pain
  • last few hours

fundoscopy is normal in 2/3 of cases
1/3 has papillitis (red, swollen optic disc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Allergic conjunctivitis (non-pharmacological and pharmacologica)

A

Nonpharmacological management

- Do not rub eye
- Remove contact lenses
- Cold compress on eyelid PRN
- Irrigation with normal saline BD
- Ocular lubricant (hylo-fresh drop OR artificial tears) 
- Avoid allergen

Pharmacological

- vasoconstriction : Naphazoline eye drop 1 drop QID
- Antihistamine
    - Patanol BD
    - Zyrtec BD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

vision loss in children (amblyopia) (4)

A

amblyopia (lazy eye)

DDx:

  • strabismus
  • refraction error
  • congenital cataract
  • retinoblastoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

vision loss in adult- gradual (6)

A
  1. refractive error: corrected by pinhole test
  2. cataract: all vision is blurred
  3. glaucoma: tunnel vision (peripheral vision impaired)
  4. retinopathy
  5. macular degeneration- dry- aged-related
  6. optic nerve atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

vision loss in adult- sudden-permanent (8)

A
  1. wet macular degeneration (central vision loss)
    • bleeding behind macula
    • fundoscopy: haemorrhage and exudate
    • urgent referral
  2. central retinal artery occlusion (central vision loss)
    • due to embolism from carotid artery - cholesterol
    • fundoscopy: cherry red haemorrhage, pale retina
    • Mx: eyeball message to dislodge emobli
      urgent referral within 30 min
      re-breath CO2 in a breathing bag
  3. central retinal vein occlusion (central vision loss)
    • Fundoscopy: stormy sunset
    • Mx: urgent referral, no initial first aid management
  4. retinal detachment (sudden onset floaters & flashes)
    • sudden vision loss: curtain
    • could be partial or total vision loss
  5. post vitreous body detachment (sudden floaters only)
    • no flashes
    • could be normal vision
    • Mx: urgent referral
  6. vitreous haemorrhage (sudden floaters, no flashes)
    • partial vision loss
    • Mx: - bed rest
      - USS
      - urgent referral
  7. temporal arteritis
  8. Stroke
17
Q

vision loss in adult- sudden-permanent (6)

A
  1. Migraine
  2. Amaurosis Fugax, could be due to
    • central retinal artery occlusion
    • transient ocular ischemia: loss of vision with activity
    • optic neuritis = Multiple sclerosis
    • TIA, stroke
    • temporal arteritis
    • benign intracranial hypertension
18
Q

Glaucoma- R/F

A 
Age
Diabetes
Hypertension
Myopia (not hyperopia)
Trauma
steroid
19
Q

Glaucoma- physical finding

A 
Mid-dilated non reactive Pupil
Decrease Visual acuity
Cornea and scleral injection
Ciliary flush
Cloudy cornea
Increase IOP
20
Q

glaucoma- medications

A

Topical cholinergic agonist (pilocarpine)
Topical B-blockers (timolol)
Topical Alpha 2 agonist (brimonidine)
Topical prostaglandin (Xalatan)

IV/PO acetazolamide: to decrease IOP

RACGP (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions